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by Robert Preidt

More Evidence That Boxing Can Lead to Brain Damage

Repeated blows to head tied to changes seen on MRIs, lower test scores, study finds
THURSDAY, Jan. 29, 2015 (HealthDay News) -- Another study supports the notion that repeated blows to the head in boxing or the martial arts can damage the brain.
The study, led by Dr. Charles Bernick of the Cleveland Clinic, included professional fighters -- 93 boxers and 131 mixed martial arts experts. They ranged in age from 18 to 44, and were compared against 22 people of similar age with no history of head injuries.
The amount of time the boxers and martial arts combatants had spent as professional fighters ranged from zero to 24 years, with an average of four years, Bernick's team said. The number of professional matches they'd had ranged from zero to 101, with an average of 10 a year.
MRI brain scans and tests of memory, reaction time and other intellectual abilities showed that the fighters who had suffered repeated blows to the head had smaller brain volume and slower processing speeds, compared to non-fighters.
While the study couldn't prove cause-and-effect, the effects were evident at a relatively young age and tied to a higher risk of thinking and memory problems, the Cleveland researchers said.
The more fights, the worse the outcomes for the brain, the study found. Gauging the number of fights a boxer or martial arts expert had engaged in, Bernick's team came up with a "Fight Exposure Score." They found that the higher the score, the lower the volume of certain brain structures, and the poorer the person's performance in "brain processing speed."
The boxers tended to fare worst: They had smaller brain volume and tested as mentally slower compared martial arts fighters, according to the study published online Jan. 29 in the British Journal of Sports Medicine.
"Perhaps the most obvious explanation is that boxers get hit in the head more," the researchers wrote. "In addition to trying to concuss (i.e. knock out) their opponent, martial arts fighters can utilize other combat skills such as wrestling and jiu jitsu to win their match by submission without causing a concussion," they added.
More information
The American Academy of Family Physicians has more about concussion (http://familydoctor.org/familydoctor/en/diseases-conditions/concussion.printerview.all.html ).
SOURCE: British Journal of Sports Medicine, news release, Jan. 29, 2015
by Robert Preidt

Teens, Young Adults Most Likely to Go to ER After Car Accidents: Report

Race also played a role, with blacks more likely to visit ER after crashes than whites, Hispanics
FRIDAY, Jan. 30, 2015 (HealthDay News) -- In a finding that won't surprise many parents, a new government analysis shows that teens and young adults are the most likely to show up in a hospital ER with injuries suffered in a motor vehicle accident.
Race was another factor that raised the chances of crash-related ER visits, with rates being higher for blacks than they were for whites or Hispanics, data from the U.S. Centers for Disease Control and Prevention indicated.
According to information in the study, there were almost 4 million ER visits for motor vehicle accident injuries in 2010-2011, a figure that amounted to 10 percent of all ER visits that year.
Crash victims were twice as likely to arrive in an ambulance as patients with injuries not related to motor vehicle crashes (43 percent versus 17 percent), the study found. However, the chances that crash victims were determined to have really serious injuries were only slightly higher than those who arrived at the ER for other injuries (11 percent versus 9 percent).
"While almost half of the patients arrived by ambulance, they were generally no sicker than patients with non-motor vehicle-related injuries and were no more likely to require admission to the hospital," said Dr. Eric Cruzen, medical director of emergency medicine at The Lenox Hill HealthPlex, a freestanding emergency room in New York City.
Cruzen -- who was not involved in the study -- noted that "most patients evaluated after motor vehicle accidents received an X-ray and/or CT scan, and were most often diagnosed with sprains, strains and contusions."
According to the study authors, Dr. Michael Albert and Linda McCaig of the CDC's National Center for Health Statistics (NCHS), "In spite of improvements in motor vehicle safety in recent years, motor vehicle crashes remain a major source of [injury and death] in the United States."
And, they wrote, "Motor vehicle-related deaths and injuries also result in substantial economic and societal costs related to medical care and lost productivity."
Age was perhaps the most compelling determinant of who arrived in the ER with a motor vehicle crash injury, with the rate peaking at 286 per 10,000 persons for those aged 16 to 24. That compared to a rate of 65 per 10,000 persons for those aged 65 and over, and 70 per 10,000 persons for those under the age of 15.
In addition, race also played a part in the likelihood of such ER visits, the findings showed.
The overall ER visit rate for motor vehicle injuries was higher among black people (260 per 10,000 persons) than among whites (119 per 10,000 persons) or Hispanics (104 per 10,000 persons), the study found.
The findings were reported Jan. 30 in the NCHS Data Brief.
More information
Find out more about teen driving safety at the Children's Hospital of Philadelphia (http://www.teendriversource.org/ ).
SOURCES: Eric Cruzen, M.D., chairman & medical director, department of emergency medicine, Lenox Hill HealthPlex, New York City; NCHS Data Brief, January 2015
by Robert Preidt

Breast Reconstruction Complications Similar for Older, Younger Women

But risk of blood clots higher with use of seniors' own tissue instead of implants
FRIDAY, Jan. 30, 2015 (HealthDay News) -- The overall risk of complications from breast reconstruction after breast removal is only slightly higher for older women than for younger women, a new study indicates.
Researchers looked at data from nearly 41,000 women in the United States who had one breast removed between 2005 and 2012. Of those patients, about 11,800 also underwent breast reconstruction.
Patients aged 65 and older were less likely to have breast reconstruction than younger women. About 11 percent of older women chose to have the surgery compared to nearly 40 percent of women under 65, the study found.
Women who had breast reconstruction had more complications -- such as longer hospital stays and repeat surgeries -- than those who did not have breast reconstruction. However, overall complication rates after breast reconstruction were similar. About 7 percent of older women had complications, while slightly more than 5 percent of younger women did.
One exception was the risk of blood clot-related complications after breast reconstruction that used a patient's own tissue instead of implants. The risk of a type of blood clot called a venous thromboembolism (VTE) was nearly four times higher among women 65 and older who had reconstruction using their own tissue. For women between 70 and 75, the risk of venous thromboembolism was more than six times higher, according to the study.
Venous thromboembolism includes deep vein thrombosis (a clot in the leg) and pulmonary embolism (a clot in the lungs). But the overall rate of venous thromboembolism was low -- just 1 percent after reconstruction using a woman's own tissue, the researchers found.
The study appears in the February issue of the journal Plastic and Reconstructive Surgery.
"Older patients should be counseled that their age does not confer an increased risk of complications after implant-based post-mastectomy breast reconstruction," Dr. Mark Sisco, of NorthShore University Health System and the University of Chicago, and colleagues wrote in a journal news release.
"However, they should be counseled that their age may confer an increased risk of VTE," they added.
Older women may need special attention to prevent venous thromboembolism after tissue-based breast reconstruction. One possibility is longer use of blood-thinning medications, the researchers said.
More information
The American Cancer Society has more about breast reconstruction (http://www.cancer.org/cancer/breastcancer/moreinformation/breastreconstructionaftermastectomy/index ).
SOURCE: Plastic and Reconstructive Surgery, news release, Jan. 28, 2015
by Robert Preidt

Colon Cancer Rates Rising Among Americans Under 50

Still, only 10 percent of cases occur in younger group, study finds
FRIDAY, Jan. 30, 2015 (HealthDay News) -- Although the overall rate of colon cancer has fallen in recent decades, new research suggests that over the last 20 years the disease has been increasing among young and early middle-aged American adults.
At issue are colon cancer rates among men and women between the ages of 20 and 49, a group that generally isn't covered by public health guidelines.
"This is real," said study co-author Jason Zell, an assistant professor in the departments of medicine and epidemiology at the University of California, Irvine.
"Multiple research organizations have shown that colon cancer is rising in those under 50, and our study found the same, particularly among very young adults," he said. "Which means that the epidemiology of this disease is changing, even if the absolute risk among young adults is still very low."
Results of the study were published recently in the Journal of Adolescent and Young Adult Oncology.
The study authors noted that more than 90 percent of those with colon cancer are 50 and older. Most Americans (those with no family history or heightened risk profile) are advised to start screening at age 50.
Despite remaining the third most common cancer in the United States (and the number two cause of cancer deaths), a steady rise in screening rates has appeared to be the main driving force behind a decades-long plummet in overall colon cancer rates, according to background information in the study.
An analysis of U.S. National Cancer Institute data, published last November in JAMA Surgery, indicated that, as a whole, colon cancer rates had fallen by roughly 1 percent every year between 1975 and 2010.
But, that study also revealed that during the same time period, the rate among people aged 20 to 34 had actually gone up by 2 percent annually, while those between 35 and 49 had seen a half-percent yearly uptick.
To examine that trend, the current study focused on data collected by the California Cancer Registry. This registry included information on nearly 232,000 colon cancer cases diagnosed between 1988 and 2009. Half the cases were in men, and over 70 percent occurred in whites.
Less than half a percent of those with colon cancer were between the ages of 20 and 29. And, about 2 percent were between the ages of 30 and 39. Around 7 percent were between the ages of 40 and 49 when diagnosed with colon cancer, according to the study.
The researchers found that between 1988 and 2009, the biannual colon cancer rates had been rising by 2.7 percent among males 20 to 29 and 40 to 49. Among males 30 to 39, the biannual increase was pegged even higher, amounting to 3.5 percent.
In young women, the increases were even higher. Women aged 20 to 29 saw a 3.8 percent biannual increase, according to the study. Those in their 30s saw a 4.5 percent increase, and women in their 40s had a 2.6 percent biannual increase, the study reported.
By contrast, both males and females in their 50s, 60s and 70s, saw a decrease in their colon cancer rates during the study period.
"We're not saying the proportion is shifting," Zell stressed. "Most colon cancer is still happening to older people. But I do think we need to do a much better job at early-age detection. Because another thing we observed is that those young adults who get colon cancer have a higher stage of cancer at diagnosis. And that has terrible implications when we look at survival."
But what exactly is driving the trend?
"That's the 20-million-dollar question right there," said Zell, who acknowledged that there is no simple explanation at hand. "But what I can say is that we need more awareness of the trend among both patients and doctors. Because at this point, key symptoms among young adults, like blood in the stool, weight loss or other complaints, are often ignored."
Dr. Andrew Chan, an associate professor in the department of medicine at Harvard Medical School, and an associate professor of medicine and gastroenterology at Massachusetts General Hospital in Boston, said the findings "should give us pause."
"Because the actual risk among young people is still quite low, I don't think by any means that these findings suggest that we need to change what we do in clinical practice," he said. "But because we don't really know why this is happening, we have to stop and consider a range of different possibilities. And really think critically about what is it about our lifestyle or environment that may be responsible of this increase in incidence."
More information
There's more on colon cancer at the American Cancer Society (http://www.cancer.org/cancer/colonandrectumcancer/ ).
SOURCES: Jason Zell, D.O., M.P.H., assistant professor, department of medicine and department of epidemiology and Chao Family Comprehensive Cancer Center, University of California, Irvine; Andrew Chan, M.D., M.P.H., associate professor, department of medicine, Harvard Medical School, and associate professor of medicine, gastroenterology, Massachusetts General Hospital, Boston; Dec. 15, 2014, Journal of Adolescent and Young Adult Oncology
by Robert Preidt

Early Exposure to English May Help Spanish-Speaking Kids in School

Hearing it at home can bolster success in classroom, researcher says
FRIDAY, Jan. 30, 2015 (HealthDay News) -- Early exposure to English helps Spanish-speaking children in the United States do better in school, a new study shows.
"It is important to study ways to increase Spanish-speaking children's English vocabulary while in early childhood before literacy gaps between them and English-only speaking children widen and the Spanish-speaking children fall behind," study author Francisco Palermo, an assistant professor in the University of Missouri College of Human Environmental Sciences, said in a university news release.
"Identifying the best ways to support Spanish-speaking children's learning of English at home and at preschool can diminish language barriers in the classroom early and can help start these students on the pathway to academic success," he added.
The study included more than 100 preschoolers who primarily spoke Spanish. The children were learning English. The researchers found that the youngsters' English vocabulary skills were better if they were exposed to English both at home and in the classroom.
When parents used English at home, it helped the kids learn and express new English words. Using English with classmates also helped the children practice new English words, according to the researchers.
"It is important for parents with limited English proficiency to continue speaking their native languages with children and to look for situations where they, other relatives, neighbors and children's playmates can expose children to English so that they can have some familiarity with English before entering preschool," Palermo suggested.
The amount of English used by teachers didn't have a significant effect on the preschoolers' English vocabularies. The quality and variety of teachers' English may be more important than the amount of English they use, according to Palermo.
"Preschool is an ideal setting to study how [Spanish-speaking] children learn language because learning in preschool occurs mainly through social interactions, and languages are learned naturally by engaging in social interactions," Palermo explained.
"Teachers should support children's native languages and encourage activities in the classroom that allow children to interact using English," he added.
The study was published recently in the journal Applied Psycholinguistics.
By 2030, as many as four in 10 students in the United States will be learning English as a second language, according to the Center for Research on Education, Diversity and Excellence.
More information
The U.S. Centers for Disease Control and Prevention has more about building languages (http://www.cdc.gov/ncbddd/hearingloss/parentsguide/building/index.html ).
SOURCE: University of Missouri, news release, Jan. 23, 2015
by Robert Preidt

Flame Retardants May Raise Risk of Preterm Births, Study Finds

Women with higher blood levels of common chemicals were more likely to deliver early
FRIDAY, Jan. 30, 2015 (HealthDay News) -- Pregnant women exposed to high levels of flame-retardant chemicals may be at increased risk for having premature babies, a new study indicates.
Researchers analyzed blood samples from pregnant women when they were admitted to hospital for delivery. Those with higher levels of flame-retardant chemicals in their bodies were more likely to have preterm babies (before 37 weeks of pregnancy) than those with lower levels of the chemicals, the investigators found.
"Nearly all women have some amount of exposure to flame-retardant chemicals. Many people have no idea that these chemicals can be found on many common items, including household dust and clothes dryer lint," study author Dr. Ramkumar Menon, an assistant professor in the department of obstetrics and gynecology at the University of Texas Medical Branch, said in a university news release.
Flame retardants have been widely used for four decades in home construction, furniture, clothing and electronic appliances, and they have been found in amniotic fluid, umbilical cord tissue, fetal tissue and breast milk, the study authors said.
More than 15 million babies around the world are born prematurely every year. About 1 million of these babies die shortly after birth, making preterm birth the second-leading cause of death in children under 5, the researchers added.
"Since stopping the use or exposure of flame retardants during pregnancy is not likely, our laboratory is currently studying the mechanisms by which flame retardants cause preterm birth," Menon said.
While the study found an association between exposure to flame-retardant chemicals and premature birth, it did not prove a cause-and-effect link.
The study was published Jan. 28 in the Journal of Reproductive Immunology.
More information
The U.S. National Institute of Child Health and Human Development has more about preterm labor and birth (http://www.nichd.nih.gov/health/topics/preterm/Pages/default.aspx ).
SOURCE: University of Texas, news release, Jan. 28, 2015
by Robert Preidt

Health Highlights: Jan. 29, 2015

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Doctors Dropping Patients Who Refuse Vaccinations
Some doctors are dropping patients who refuse to get their children vaccinated.
This tough approach to patients who still believe discredited research linking vaccines to autism is meant to get them to change their minds, or at least keep other patients safe, the Associated Press reported.
One of those doctors is Dr. Charles Goodman, a pediatrician in Los Angeles. A notice in his waiting room says he will no longer see children whose parents won't get them vaccinated.
"Parents who choose not to give measles shots, they're not just putting their kids at risk, but they're also putting other kids at risk -- especially kids in my waiting room," he told the AP.
With at least 98 cases reported since last month, the United States is in the midst of its second-largest measles outbreak in the last 15 years.
Doctors should emphasize the importance of vaccinations but should respect a parent's wishes unless there is a significant risk to the child, the American Academy of Pediatrics says.
"In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child," the group's guidelines say, the AP reported.
Obama to Launch Research Program Focused on Personalized Medicine
Personalized medicine is the focus of a major research program to be announced Friday by President Barack Obama.
Administration officials said it will include the collection of genetic data on one million Americans in order to help scientists develop drugs and other treatments tailored to individual patients' characteristics, The New York Times reported.
The initiative will help doctors determine which treatments work best for which patients, according to Dr. Francis Collins, director of the National Institutes of Health.
The research program would begin with an initial $215 million included in the president's budget request for the fiscal year that starts on Oct. 1, The Times reported.
"Many details about how this initiative is going to be designed and operated are still in the process of being worked out," Collins said. The government will create a panel of advisers to "help us put real specifics into what is now an exciting but somewhat general plan."
Since the 1990s, scientists have been collecting and storing human tissue and other biological specimens in what are called biobanks.
"We do not envision this as being a biobank, which would suggest a single repository for all the data or all the samples," Jo Handelsman, associate director of the White House Office of Science and Technology Policy, told The Times.
"There are existing cohorts around the country that have already been started and have rich sources of data. The challenge in this initiative is to link them together and fill in the gaps," Handelsman explained.
The data collected in the new initiative would include laboratory test results, medical records, information about people's diet, lifestyle, environment and tobacco use, and profiles of patients' genes, The Times reported.
Patients will help shape the research program and their "privacy will be rigorously protected," according to Handelsman.
She noted that "patients with breast, lung and colorectal cancers routinely undergo molecular testing as part of their care," and doctors use the results of these tests to help them select treatments most likely to benefit patients.
The initiative was praised by Mark Fleury, a policy analyst at the American Cancer Society's Cancer Action Network.
"Cancer is a disease of faulty genes. The goal of personalized medicine is to understand the unique characteristics of individual patients so therapies can be tailored to genetic mutations that underlie their disease," he told The Times.
Surge in Medicare Payments for Procedure That Unblocks Vessels in Limbs
Some cardiologists are making millions of dollars from Medicare by performing controversial techniques to open blocked veins and blood vessels in the arms and legs.
This has occurred as procedures to open blocked heart arteries have come under increasing scrutiny, The New York Times reported.
While procedures to unblock heart arteries must be done in a hospital or outpatient facility, treating blood vessel and vein blockages in the arms and legs can be done in a doctor's office.
However, many experts believe such blockages are more safely treated with drugs and exercise, The Times reported.
Between 2005 and 2013, the number of procedures to open blocked heart vessels in Medicare patients fell about 30 percent to 323,000, while the number of procedures to open blocked vessels outside the heart rose 70 percent to 853,000, according to the Advisory Board Company, a research firm that analyzed Medicare payment data.
An analysis of 2012 billing records from the nation's 10 top-billing cardiologists showed that eight of them made about half of their Medicare reimbursements by performing procedures to open narrowed arteries or veins in patients' arms or legs, The Times reported.
Other specialists who are among the top billers for such procedures include some radiologists and vascular surgeons.
The procedures are financially rewarding. In 2012, Medicare paid nearly $12,000 for one type of these operations, The Times reported.
by Robert Preidt

Health Tip: Drink Responsibly

Suggestions to prevent alcohol abuse
(HealthDay News) -- Responsible drinking is a surefire way to prevent alcohol abuse and alcohol poisoning, a dangerous complication of drinking too much.
The U.S. Centers for Disease Control and Prevention suggests:
Don't over-drink or binge drink. Don't mix alcohol with energy drinks. The caffeine in energy drinks may mask the effects of alcohol and lead to drinking too much. Avoid drinks with an unknown amount of alcohol. If you see anyone with signs of alcohol abuse, seek immediate help. Seek help if you think you have a drinking problem.
by Robert Preidt

Lead Exposure May Be Bigger Threat to Boys Than Girls

Hormones may offer young females some protection from toxic effects, study says
FRIDAY, Jan. 30, 2015 (HealthDay News) -- Hormones may explain why lead exposure is less likely to cause brain damage in girls than in boys, researchers report.
Specifically, the female hormones estrogen and estradiol may help protect against lead's harmful effects on the frontal areas of the brain, according to the findings published recently in the Journal of Environmental Health.
"The study supports existing research suggesting that estrogen and estradiol in females may act as neuroprotectants against the negative impacts of neurotoxins," study author Maya Khanna, a psychology professor at Creighton University, said in a university news release.
The study included 40 children. They were between the ages of 3 and 6, and all lived in an area of Omaha considered the largest residential lead clean-up site in the United States. The area has high levels of lead contamination in the soil due to emissions from a lead refinery that operated there for 125 years.
Also, many homes in the area are old and still have lead-based paint.
The researchers found that 23 of the children had elevated blood lead levels. Boys with elevated lead levels scored low on tests of memory, attention and other thinking abilities. Girls with elevated lead levels did not do as poorly on the tests, according to the study.
The researchers also found that elevated lead levels had a much stronger negative impact on thinking abilities than on reading readiness.
This is the first study to show that very young children already experience harm from lead exposure, and that lead has a greater impact on thinking abilities in boys than in girls, according to Khanna.
More information
The U.S. Centers for Disease Control and Prevention has more about lead (http://www.cdc.gov/nceh/lead/ ).
SOURCE: Creighton University, news release, Jan. 23, 2015
by Robert Preidt

More Measles Cases Seen in January Than in Typical Year: CDC

Spread driven largely by outbreak that started at Disney theme parks in California in December
THURSDAY, Jan. 29, 2015 (HealthDay News) -- The United States has seen more cases of measles in January than it usually does in an entire year, federal health officials said Thursday.
A total of 84 cases in 14 states were reported between Jan. 1 and Jan. 28, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention, said during an afternoon news conference.
That's more in one month than the average 60 measles cases each year that the United States saw between 2001 and 2010, said Schuchat, who is also Assistant Surgeon General of the U.S. Public Health Service.
"It's only January, and we've already had a very large number of measles cases -- as many cases as we have all year in typical years," she said. "This worries me, and I want to do everything possible to prevent measles from getting a foothold in the United States and becoming endemic again."
January's numbers have been driven largely by the multi-state measles outbreak that originated in two Disney theme parks in California in December, Schuchat said.
There have been 67 cases of Disney-related measles reported since late December, occurring in California and six other states, she said. Of those, 56 are included in the January count. About 15 percent of those infected have been hospitalized, she added.
Schuchat pointed the finger directly at a lack of vaccination for the Disney cases.
"The majority of the adults and children that are reported to us for which we have information did not get vaccinated, or don't know whether they have been vaccinated," she said. "This is not a problem of the measles vaccine not working. This is a problem of the measles vaccine not being used."
Public health officials are particularly concerned because the Disney outbreak comes on the heels of the worst year for measles in the United States in two decades, Schuchat said.
In 2014, there were more than 600 cases of measles, the most reported in 20 years. Many were people who contracted measles from travelers to the Philippines, where a massive outbreak of 50,000 cases had occurred, Schuchat explained.
The United States declared measles eliminated in 2000, meaning that the virus is no longer native to this country.
But measles still rages abroad, and can re-enter the United States to infect vulnerable people through travelers, Schuchat noted.
"Although we aren't sure how exactly this year's outbreak began, we assume that someone got infected with measles overseas, visited the Disneyland parks and spread the disease to others," she said.
The CDC estimates there are about 20 million cases of measles worldwide each year, and in 2013 almost 146,000 people died from the highly infectious disease, Schuchat said. For every 1,000 children who get measles, two to three die, she added.
Parents whose children are not vaccinated against measles should get them immunized, she said, and adults who aren't sure about their vaccination history should get a booster dose as well.
"For adults out there, if you're not sure if you've had measles vaccine or not, we'd urge you to contact your doctor or nurse and get vaccinated," Schuchat said. "There's no harm in getting another MMR vaccine if you've already been vaccinated."
A trickle of measles cases have always flowed into the United States as a result of travel between countries. In January, doctors have seen cases here linked to travel to Indonesia, Azerbaijan, India and Dubai, Schuchat said.
Measles is incredibly infectious, even more so than Ebola, officials explained.
"It's so contagious that if one person has it, 90 percent of the people close to that person who aren't immune will also become infected," Schuchat said. "You can become infected by being in the same room as a person who has measles, even if that person already left the room, because the virus can hang around for a couple of hours."
Unfortunately, many parents are not getting their children vaccinated against measles.
"These outbreaks the past couple of years have been much harder to control when the virus reaches communities where numbers of people have not been vaccinated," Schuchat said.
More information
Visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/measles/ ) for more on measles.
SOURCE: News conference with: Anne Schuchat, M.D., director, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, and Assistant Surgeon General, U.S. Public Health Service

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